The Fascial Manipulation Method is a cycle of articles dedicated to the understanding of themost common dysfunctions we meet during our clinical practice, specifically theirmanifestation and treatment with Fascial Manipulation. FM specialists report clinical cases,accurately describing their symptomatology, the chosen work plan and the resultsobtained, thanks to the treatment. For privacy reasons, the names of the patients have been changed.

Clinician: Riccardo Libralesso

Aim of the study: To demonstrate the effectiveness of the treatment of Fascial Manipulation® in cases of acute pain in neck and arm, verify both the reduction of pain symptoms and the recovery of segmental mobility.

Introduction: L.M., a 38-year-old employee, presents to the clinic with pain in the neck and right arm of 3 months origin, greater in the posterior area of the scapula, occurring without apparent trauma. Pain level increased steadily, plateauing for the last few weeks.
The pain is very intense (VAS 6) and compromises all his daily activities, in particular flexion and extension movements, neck rotations, with the same intensity, sitting position in the office and driving a car.
The concomitant pains are a chronic back pain and left coxalgia. The patient reports a varicocele and left hydrocele surgery 10 years ago.

Method: In the movement verification, the most compromised plane appears to be the horizontal, with a cervical rotation ROM reduced by 50%, followed by the sagittal (flexion and extension). The palpation verification confirms this hypothesis. Therefore the choice falls first on the horizontal plane.

We will start with treatment of the left pelvis (left ir-pv) for left coxalgia, away from the painful site, due to the strong pain and the fact that the pain radiates.
We continue on the same sequence (er-th rt), to improve the sliding of the fascia in the proximal–distal direction, then moving anteriorly (ir-th rt), to balance its antagonist. Progressively, we will treat the contralateral densifications (er-th lt, ir-th lt and rt) to restore balance to the trunk.
After this first treatment, we repeat the movement verification. Flexion ROM improved by 30% with a reduction in pain (VAS 5).

The second session is set for three days later. The results obtained in the first treatment have been maintained. We therefore examine again the horizontal plane. After dissolving the densification in only a single point (er-cl rt), the motor checks on the two planes become negative, with minimal limitations in ROM at maximum degrees of movement and pain (VAS 2).

Result : One week after the second treatment, L.M. is now able to restart his job and his gym activities without joint pain or limitations. These Improvements will remain at a follow-up visit, one month later.

Conclusion: Fascial Manipulation® has proved to be able to safely and effectively address a significant pain in the acute phase, in this case at the cervical level, treating far from the pain site, the near-distal sites, balancing the two halves of the trunk, agonist with antagonists. The correct fascial sliding was restored, with consequent recovery of the joint range and decrease of pain symptoms.

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